Patients’ and carers’ experiences of interacting with home haemodialysis technology: implications for quality and safety

BMC Nephrology

Ann Blandford¹  Diane Walker⁴  Astrid Mayer²  Ken Farrington³  Atish Rajkomar¹ 

[1] UCL Interaction Centre, University College London, London, UK;UCL Medical School, University College London, London, UK;Renal Medicine, East and North Hertfordshire NHS Trust, Stevenage, UK;Renal Unit, Royal Free Hospital, London, UK

关键词: User-computer interface;    Patient satisfaction;    Patient safety;    Medical device design;    Human factors;    Home haemodialysis;   

Others  :  1082536
DOI  :  10.1186/1471-2369-15-195

 received in 2014-08-29, accepted in 2014-11-27,  发布年份 2014

【 摘 要 】

Background

Little is known about patients’ and carers’ experiences of interacting with home haemodialysis (HHD) technology, in terms of user experience, how the design of the technology supports safety and fits with home use, and how the broader context of service provision impacts on patients’ use of the technology.

Methods

Data were gathered through ethnographic observations and interviews with 19 patients and their carers associated with four different hospitals in the UK, using five different HHD machines. All patients were managing their condition successfully on HHD. Data were analysed qualitatively, focusing on themes of how individuals used the machines and how they managed their own safety.

Results

Findings are organised by three themes: learning to use the technology, usability of the technology, and managing safety during dialysis. Home patients want to live their lives fully, and value the freedom and autonomy that HHD gives them; they adapt use of the technology to their lives and their home context. They also consider the machines to be safe; nevertheless, most participants reported feeling scared and having to learn through mistakes in the early months of dialysing at home. Home care nurses and technicians provide invaluable support. Although participants reported on strategies for anticipating problems and keeping safe, perceived limitations of the technology and of the broader system of care led some to trade off safety against immediate quality of life.

Conclusions

Enhancing the quality and safety of the patient experience in HHD involves designing technology and the broader system of care to take account of how individuals manage their dialysis in the home. Possible design improvements to enhance the quality and safety of the patient experience include features to help patients manage their dialysis (e.g. providing timely reminders of next steps) and features to support communication between families and professionals (e.g. through remote monitoring).

【 授权许可】

   
2014 Rajkomar et al.; licensee BioMed Central Ltd.

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